Comparison of oncological outcomes of single-port versus multi-port video-assisted thoracoscopic surgery for non-small-cell lung cancer: a propensity-matched analysis

Abstract

Purpose: There are few reports about oncological outcomes of single-port (SP) video-assisted thoracoscopic surgery (VATS) lobectomy, represented by overall survival (OS), disease-free survival (DFS), and adequacy of lymph node retrieval. We designed this study to analyze the oncological outcomes of SP versus multi-port (MP) VATS lobectomy for non-small-cell lung cancer (NSCLC). Methods: From January 2012 to February 2014, 243 consecutive patients undergoing VATS lobectomy for NSCLC were enrolled. Intention-to-treat analysis with propensity score matching was conducted to compare the oncological outcomes between SP and MP VATS lobectomy for NSCLC. Results: Seventy-three patients underwent SP VATS lobectomy, and 154 patients underwent conventional MP VATS lobectomy. Propensity score matching created 63 patients in each group. The median follow-up was 65.8 and 72.5 months in the SP and MP VATS groups, respectively. No significant differences were observed in the number of resected lymph nodes (14.6 vs. 16.1, P=0.329), number of resected mediastinal lymph node stations (2.3 vs. 2.5, P=0.091), and postoperative complications. The OS at 5 years was 89.9% and 86.9% in the SP and MP VATS groups, respectively (log-rank test, P=0.344). The DFS at 5 years was 75.1% and 75.7% in the SP and MP VATS groups, respectively (log-rank test, P= 0.899). Conclusion: There were no significant differences in oncological outcomes of SP VATS lobectomy for NSCLC and those of MP VATS lobectomy.